| 1. |
- Chaparro, M. Pia, et al.
(author)
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Effects of Parental Nativity and Length of Stay in the US on Fruit and Vegetable Intake Among WIC-Enrolled Preschool-Aged Children
- 2015
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In: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 17:2, s. 333-338
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Journal article (peer-reviewed)abstract
- Exposure to US culture is negatively associated with fruits and vegetables (F&V) intake. Our goal was to investigate how parent's nativity and length of stay in the US influences preschoolers' F&V intake. We analyzed survey data from 2,352 children, aged 36-60 months, who participate in the Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County. Using multiple linear regression, we examined children's F&V intake by parent's nativity and years in the US, adjusting for possible confounders. Children of foreign born parents who had lived in the US for < 10 years consumed fewer servings of vegetables than children of US born parents and of foreign born parents who had lived in the US for a parts per thousand yen10 years. Children of newer immigrant families may be at greater risk for consuming poor-quality diets. Research to identify determinants of poor diet quality among children of immigrant families may increase the effectiveness of WIC in addressing this population's nutritional needs.
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| 2. |
- Chaparro, M. Pia, et al.
(author)
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Influences of the neighbourhood food environment on adiposity of low-income preschool-aged children in Los Angeles County : a longitudinal study
- 2014
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 68:11, s. 1027-1033
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Journal article (peer-reviewed)abstract
- Background Few studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the longitudinal association between neighbourhood food environment and adiposity among low-income preschool-aged children in a major metropolitan region in the USA. Methods The study sample was 32 172 low-income preschool-aged children in Los Angeles County who had repeated weight and height measurements collected between ages 2 and 5 years through a federal nutrition assistance programme. We conducted multilevel longitudinal analyses to examine how spatial densities of healthy and unhealthy retail food outlets in the children's neighbourhoods were related to adiposity, as measured by weight-for-height z-score (WHZ), while controlling for neighbourhood-level income and education, family income, maternal education, and child's gender and race/ethnicity. Results Density of healthy food outlets was associated with mean WHZ at age 3 in a non-linear fashion, with mean WHZ being lowest for those exposed to approximately 0.7 healthy food outlets per square mile and higher for lesser and greater densities. Density of unhealthy food outlets was not associated with child WHZ. Conclusions We found a non-linear relationship between WHZ and density of healthy food outlets. Research aiming to understand the sociobehavioural mechanisms by which the retail food environment influences early childhood obesity development is complex and must consider contextual settings.
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| 3. |
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| 4. |
- Chaparro, M. Pia, et al.
(author)
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Association between food assistance program participation and overweight
- 2014
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In: Revista de Saude Publica. - 0034-8910 .- 1518-8787. ; 48:6, s. 889-898
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS: A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural), and survey year (2003-2006 versus 2008-2010). The models were adjusted for age, education level, urbanization, and survey year. RESULTS: Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR) = 1.29; 95% confidence interval (CI) 1.06; 1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS: Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition.
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| 5. |
- Chaparro, M. Pia, et al.
(author)
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Childhood family structure and women's adult overweight risk : A longitudinal study
- 2017
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:5, s. 511-519
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Journal article (peer-reviewed)abstract
- AIM: The aim of this study was to investigate whether women's adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers' marital status history, during the women's first 18 years of life.METHODS: Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19-35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women's overweight/obesity (body mass index (BMI) ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)) and the predictor was mothers' marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women's age and maternal sociodemographic characteristics.RESULTS: Mothers' marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15-1.19; p < 0.05); and (2) women whose mothers belonged to the stable cohabitation (OR = 1.31; 95% confidence interval (CI) = 1.14-1.52), cohabiting then separating (OR = 1.23; 95% CI = 1.01-1.49), varied transitions (OR = 1.24; 95% CI = 1.11-1.39), and not with father (OR = 1.24; 95% CI = 1.00-1.54) clusters had higher odds of obesity.CONCLUSIONS: Women whose mothers were not in stable marriage relationships had higher odds of being overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.
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| 6. |
- Chaparro, M Pia, et al.
(author)
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Maternal pre-pregnancy BMI and offspring body composition in young adulthood : the modifying role of offspring sex and birth order.
- 2017
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In: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 20:17, s. 3084-3089
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate if the association between maternal pre-pregnancy BMI and offspring's body composition in late adolescence and young adulthood varies by offspring birth order and sex.DESIGN: Family cohort study, with data from registers, questionnaires and physical examinations. The main outcome under study was offspring body composition (percentage fat mass (%FM), percentage lean mass (%LM)) measured by dual-energy X-ray absorptiometry.SETTING: Uppsala, Sweden.SUBJECTS: Two hundred and twenty-six siblings (first-born v. second-born; average age 19 and 21 years) and their mothers.RESULTS: In multivariable linear regression models, maternal pre-pregnancy BMI was positively associated with daughter's %FM, with stronger estimates for first-born (β=0·97, 95 % CI 0·14, 1·80) v. second-born daughters (β=0·64, 95 % CI 0·08, 1·20). Mother's BMI before her first pregnancy was associated with her second-born daughter's body composition (β=1·05, 95 % CI 0·31, 1·79 (%FM)) Similar results albeit in the opposite direction were observed for %LM. No significant associations were found between pre-pregnancy BMI and %FM (β=0·59, 95 % CI-0·27, 1·44 first-born; β=-0·13, 95 % CI-0·77, 0·52 second-born) or %LM (β=-0·54, 95 % CI-1·37, 0·28 first-born; β=0·11, 95 % CI-0·52, 0·74 second-born) for sons.CONCLUSIONS: A higher pre-pregnancy BMI was associated with higher offspring %FM and lower offspring %LM in late adolescence and young adulthood, with stronger associations for first-born daughters. Preventing obesity at the start of women's reproductive life might reduce the risk of obesity in her offspring, particularly for daughters.
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| 7. |
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| 8. |
- Heshmati, Amy, et al.
(author)
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Early life characteristics, social mobility during childhood and risk of stroke in later life : findings from a Swedish cohort
- 2017
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:4, s. 419-427
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Journal article (peer-reviewed)abstract
- Aims: To investigate if early life characteristics and social mobility during childhood are associated with incident thrombotic stroke (TS), haemorrhagic stroke (HS) and other stroke (OS). Methods: Our study population consists of all live births at Uppsala University Hospital in 1915-1929 (Uppsala Birth Cohort; n = 14,192), of whom 5532 males and 5061 females were singleton births and lived in Sweden in 1964. We followed them from 1 January 1964 until first diagnosis of stroke (in the National Patient Register or Causes of Death Register), emigration, death, or until 31 December 2008. Data were analysed using Cox regression, stratifying by gender. Results: Gestational age was negatively associated with TS and OS in women only. Women had increased risk of TS if they were born early preterm (<35 weeks) (HR 1.54 (95% CI 1.02-2.31)) or preterm (35-36 weeks) (HR 1.37 (95% CI 1.03-1.83)) compared to women born at term. By contrast, only women who were early preterm (HR 1.98 (95% CI 1.27-3.10) had an increased risk of OS. Men who were born post-term (42 weeks) had increased risk of HS (HR 1.45 (95% CI 1.04-2.01)) compared with men born at term, with no association for women. TS was associated with social mobility during childhood in women: women whose families were upwardly or downwardly mobile had increased risk of TS compared to women who were always advantaged during childhood. Conclusions: Gestational age and social mobility during childhood were associated with increased risk of stroke later in life, particularly among women, but there was some heterogeneity between stroke subtypes.
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| 9. |
- Holowko, Natalie, et al.
(author)
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Social inequality in pre-pregnancy BMI and gestational weight gain in the first and second pregnancy among women in Sweden
- 2015
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 69:12, s. 1154-1161
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Journal article (peer-reviewed)abstract
- BACKGROUND: High pre-pregnancy body mass index (BMI) and inappropriate gestational weight gain (GWG) are associated with adverse short and long-term maternal and neonatal outcomes and may act as modifiable risk factors on the path to overweight/obesity, but their social patterning is not well established. This study investigates the association of education with BMI and GWG across two consecutive pregnancies.METHODS: The study includes 163 352 Swedish women, having their first and second singleton birth in 1982-2010. In both pregnancies, we investigated the association of women's education with (1) pre-pregnancy weight status and (2) adequacy of GWG. We used multinomial logistic regression, adjusting for child's birth year, mother's age and smoking status.RESULTS: Overall, the odds of starting either pregnancy at an unhealthy BMI were higher among women with a low education compared to more highly-educated women. Lower education also predicted a greater increase in BMI between pregnancies, with this effect greatest among women with excessive GWG in the first pregnancy (p<0.0001 for interaction). Education was also inversely associated with odds of excessive GWG in both pregnancies among healthy weight status women, but this association was absent or even weakly reversed among overweight and obese women.CONCLUSIONS: Lower educated women had the largest BMI increase between pregnancies, and these inequalities were greatest among women with excessive GWG in the first pregnancy. The importance of a healthy pre-pregnancy BMI, appropriate GWG and a healthy postpartum weight should be communicated to all women, which may assist in reducing existing social inequalities in body weight.
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